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Scoliosis linked to inability to utilize manganese

These X-rays are before (L) and after bracing of a girl with scoliosis. A study found the curvature of the spine has been linked to the body's inability to utilize the essential dietary mineral manganese.

By Allen Cone, UPI

A curvature of the spine known as scoliosis has been linked to the body's inability to utilize the essential dietary mineral manganese, according to a study.

Researchers at Washington University School of Medicine in St. Louis found children with severe scoliosis are twice as likely to carry a gene variant that makes it difficult for their cells to take in and use manganese compared with children without the disease. The findings were published Tuesday in the journal Nature Communications.

"Our goal in studying the genetics of this disorder was to see if there was anything we could learn that might change how we treat patients," senior author Dr. Christina Gurnett, a professor of neurology, orthopedic surgery and pediatrics at Washington University, said in a press release. "And we came across this gene variant that affects the level of manganese in the body. That tells me maybe we should start thinking about studying nutritional treatments for some children at risk."

Growing bones and cartilage require manganese.

"Our study links a common disease -- scoliosis -- to something that's potentially modifiable in the diet," Gurnett said. "But we don't want people to go out right now and start manganese supplements, because we already know that too much manganese can be harmful."

Scoliosis affects 2 percent to 3 percent of the U.S. population and mainly develops in children 10-15 years old, according to the American Association of Neurological Surgeons.

Most new cases of scoliosis are mild and require only that doctors keep an eye on the condition. Once they develop a moderate bend to their spine, they may need to wear a back brace until they finish growing. In rare cases, surgery may be required.

Although cases of scoliosis tend to cluster in families, the researchers felt many different genes play a small role in increasing the risk of the disease.

The researchers scanned all the genes in 457 children with severe scoliosis and 987 children without the disease.

A variant in the gene SLC39A8 was found in only 6 percent of the healthy children but 12 percent of the children with severe scoliosis.

A second analysis of a separate group of 1,095 healthy children and 841 children with moderate to severe scoliosis confirmed the findings. Children with scoliosis were about twice as likely to carry the variant.

"The genetic variant does not stop the gene from working entirely, it's just not working optimally," first author Dr. Gabriel Haller said. "So maybe most people need a certain level of manganese in their blood, but if you have a bad gene variant like this one, you need more."

And when researchers bred zebrafish with a disabled SLC39A8 gene, they developed movement and skeletal abnormalities, including curves in their spines.

"We've started doing these studies in zebrafish by adding manganese to their water," Gurnett said. "But we still need to do human studies to figure out how much exactly is both safe and effective."

High doses can cause manganism, which is a permanent neurological condition characterized by tremors and difficulty walking, as well as psychiatric symptoms that include aggression and hallucinations. Also linked to the high levels are Parkinson's disease, schizophrenia and high blood pressure.

Conversely, a manganese deficiency can result in problems metabolizing fat and sugar, impaired growth, difficulty walking and curvature of the spine, according to animal studies. But it's rarely seen in people because the human body needs only trace amounts, which are obtained from food.

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